O uso do ácido tricloroacético para avulsão química de unhas com onicomicose. Relato de caso
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Abstract
Objective: To describe the use of trichloroacetic acid 90% (90% ATA) as a chemical adjuvant for avulsion of nails with onychomycosis, verifying risks and benefits to the patient. Method: This is a case report study, in which 26 individuals with a diagnostic hypothesis of onychomycosis participated. The nails were quantified, measured, photographed and classified into distal subungual onychomycosis and proximal subungual onychomycosis, according to the lunula involvement. The intervention consisted of mechanical avulsion of the contaminated nail plate and application of ATA 90% to the residual nail plate, on the exposed nail bed and nail region. On subjects' return, after 7 days, the effects of ATA 90% were observed. Results: ATA 90% did not cause the desired chemical effect of detachment of the nail plate, but it did cause the skin to peel in the areas where it was applied. The partial reduction in nail size was the result of the onychectomy technique with an appropriate instrument performed by the podiatrist. Conclusion: The mechanical avulsion of the nail and the peeling of the skin caused by ATA 90% can benefit the patient in the treatment of onychomycosis by improving the local appearance and motivating him to self-care and treatment. The podiatrist can assist the health team with the management of fungal contamination and with the education of patients.
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